Diabetes is a global epidemic now, which according to the WHO, will be the 7th leading cause of death by 2030. This silent disease is a growing threat to health worldwide. While a lot of information about diabetes is generally available in public domain, there’s very little awareness about the oral manifestations and complications of diabetes.

The link between diabetes and oral health problems is high blood sugar. Uncontrolled diabetes weakens the white blood cells which are the body’s first line of defence leading to infections in the oral cavity. Effective control of blood sugar helps decrease the likelihood of major complications due to diabetes in multiple organs like heart, lungs, kidneys, eyes as well as the oral cavity.

The most debilitating effect of diabetes in the oral cavity is on the periodontium i.e the structures supporting the teeth – gums and bone. Regardless of the severity of plaque accumulation in a person’s mouth, patients with diabetes experience various degrees of gingivitis, periodontits (commonly known as pyorrhea) and bone loss around the teeth. Periodontitis is characterized by bleeding or swollen gums, pockets between and around the teeth where food can easily get lodged and tooth mobility. These characteristics are more severe with uncontrolled diabetes.

There is recent evidence which indicates that the bacteria that enter the bloodstream as a result of gum disease, contribute to insulin resistance and destruction of pancreatic islet cells, which are responsible for making the hormone insulin which helps control blood sugar levels.

Another common complaint of diabetic patients is that of dry mouth which can be a result of excessive blood glucose associated dehydration or impaired function of the salivary glands. In the long run, dry mouth can lead to dental caries, gum diseases and bad breath, oral ulcers and taste disturbances.

Oral fungal infections occur with greater frequency in poorly controlled diabetes. Burning mouth is a common symptom in diabetic patients with fungal infections. Smokers who are diabetic are twenty times more likely to develop fungal infections and gum diseases.

In conclusion, as with other body systems, diabetes has a detrimental effect on the oral cavity as well but with proper care, good oral hygiene practices and regular checkups, diabetics can avoid all major dental and oral complications of diabetes.

Dental and oral surgical treatment in Diabetic patients needs to be done with proper care and multiple precautions pre – procedurally, during the procedure and post-operatively. Poor healing of oral tissues after surgical procedures is a major cause of concern in diabetic patients.

It is therefore imperative for diabetic patients to maintain strict oral hygiene by brushing twice daily and prevent plaque buildup by flossing. Regular check ups with the dentist are a must to prevent dental and oral diseases due to diabetes and to undergo routine oral prophylaxis. Patients must also consult their dentist about how regularly they would need dental checkups. Denture wearing diabetic patients must take special care and remove and clean their dentures regularly.

Smokers and other tobacco product addicts must consult their doctors to quit the habit. Diabetes and tobacco make a deadly combination.

Dr. Uday Singnapurkar completed his Bachelor’s degree in Dental Surgery from SPDC, Sawangi ,Wardha in 2000 and has done multiple courses on cosmetic dentistry. He runs two Dental and Oral Health care centres in Nagpur. You can find him on Twitter @MindExcavator